Case Study: Cardiac Failure

Question 1

What is a sign of infection?

Answer 1

Decreased BP
Increased HR

Question 2

What is normal HR?

Answer 2

60-100

Question 3

What are the 2 types of CCB?

Answer 3

Peripheral
Inotropic

Question 4

What is Class I of the NYHA Classification?

Answer 4

Ni limitations to physical activity

Question 5

What is Class II of the NYHA Classification?

Answer 5

Slight limitation to physical activity

Question 6

What is Class III of the NYHA Classification?

Answer 6

Marked limitation to physical activity

Question 7

What is Class IV of the NYHA Classification?

Answer 7

Unable to carry on any physical activity without discomfort

Question 8

What counselling do you give about loop diuretics?

Answer 8

Take in the morning
= make you go toilet frequently
= at night fall risk = groggy + dark

Question 9

What should you do first?

Answer 9

Stop CCB
Titrate up Ramipril
Titrate up bisoprolol (cardioselective beta-blocker)

Question 10

What are the 5 pillars of HF treatment?

Answer 10

ACEi or ARB
Beta-blocker
MRA
ARNi
SGLT2i

Question 11

What is Entresto?

Answer 11

ARNi
= angiotensin II receptor Neprilysin inhibitor

Question 12

When is Entresto used?

Answer 12

Only in really chronic HF
Stop Ramipril then start it

Question 13

When is SGLT2i only to be started?

Answer 13

If patient is on 4/5 pillars

Question 14

What are the only 2 licensed SGLT2i medicines?

Answer 14

Dapagliflozin
Empagliflozin